HomeMy WebLinkAbout020-1439-23-000onsin Department of Commerce PRIVATE SEWAGE SYSTEM
;ty and Buading Division
` INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
?ersonal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
permit Holder's'Name: City Village X Township
Rosam~i LLC Hudson, T wn of
;ST BM Elev: Insp. BM Elev: ~ BM Description: ~x ~bk IM.
crD .a' ao . b Q s ~ ~- ~.~
TANK INFORMATION Lei( p ~ 5 ~ TION DAT
county: St. Croix
Sanitary Permit No:
488141 ~
State Plan ID No: ~ /' A
SAY/ /`t ~-----__
Parcel Tax No:
020-1439-23-000
SectionlTown(Range/Map No:
(t 25.29.19.2749
TYPE ~~~_ ~RE13\~f
'~^ CAPACITY
Septic
Dosing
Aeration
Ho mg
TANK SETBACK INFORMATION
. en o it n a e
ep Ic
-.. ~ Z 2 r
~7
osing
era ion
o Ing
PUMP/SIPHON INFORMATION
anu a urer eman
GPM
o e um r
I n Ion oss ys em a
orc e g I .
.J;rO1L ACfjVKir 11VrV .1. TJ I C1Yy 11f ~,-~,,.tpAAf~..
STATION BS HI FS ELEV.
Benchmark ,~. ~ p,~
0'-'
~. Z ~
0'D . D
Alt. BM
Bldg. ewer ~ ~ ~ (S,~
t/Ht net ~~ I ~ I z~ I ~,
t t ute ,~ 1 ~r
ne
0 om ~ ~~
ea er an.
t
Is . Ipe
I ~}. ~ l S
g`~. 39 '
o . ys em C i 3•`f~
Ina ra e
S, So -
. ~ J L
~jr.c-f~ t~O
wer ~ ~ r: S.vr w
~-~ ~' ~ ~ cz~ O
Vb ~ II
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DIME ~
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Z
2q. .
INFORMATION CHAMBER OR
G~~' ~ ~
Ls'
1 g' UNIT
~-
ula I I~IPN I ww .~~ ~ ~ cm
~. ~
s.,
Length Dia Length Dia Spacing z
JVIL V-CIYGR x rressure systems unly xx rvlOUna yr t+i-vraue ~ys~ema Vu~y
BedlTrench Center
Bed/Trench Edges
Topsoil
'' ~ Yes ! No I Yes '' No
~.
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1 ti~/~L~~ Inspecti` n #2:
III' Location: 795 Highlander Circle Hudson, WI 54016 (NE 1/4 NE 1/4 25 T29N R19W) Indigo Ponds Lot 2 ~ P rcel No: 25.29.19.2749,
~ 1.) Alt BM Description ~~
2.) Bldg sewer length = _ 23 ~c~ ""'~_ ~''~" S ~ I ~%~' ~ "" 1-_ 1-n ~~
I -amount of cover = > ~0 v S~ ~U ~ '~Ca ~ w ~~'~^ S~ ~~-~s.~E~ dl ~
t tea. ~~, . - '
S
~, - -~.~ ,
Plan revision Required? [~ Yes No ~ -
Use other side for additional informati ~/ ~~ _ _; __ I
_ - -- -Card:-No: _ _
I SBD-6710 (R.3/97) '
L
P T PLAN
PR03ECT Rosamii LLC ADDRESS 2141 Ctv RD C New Richmond IN 54017
NE 'I /a NE 1/as 25 /T 2~ /R 19 w TowN Hudson counTV ST.CROIx
Iti1PRS Shaun Bird 226900 -T ~` _ DATE 5/3106 BEDROOM 4
CONVENTIONAL X~( IN-GROUN PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 900 ~ of chambers 36
,BENCHMARK V.R.P. Top of Foundation ASSUME ELEVATION 100' Filter Zabel A-100
^ BOREHOLE O WELL "`y.R.P. Same as Benchmark
Plans Designed Using
Conventional Powts ~ ~ M ELEVATION 82,8/83.8 5.5' below grade
Manual Version 2.0
Well is to meet all
setbacks required by
WDNR
nVent
>6"
of Cover
11"
5' Long
Cells have a arc to them, they
accualIy curve more than this
drawing shows
Arc 36 Biodiffu ~t--- ____
Leaching Chamber
with 25 ft2 of Area
at System Elevation g M
For Replacement area
See original soil test
done by dave steel
Pro 4
Bedroom
House
B-3
30' ST
ents
18% Slope
50
Property Line
Property Line
RECEIVED
JUL 2 6 2006
ST. CROIX GOUNTY
HighJanderTrail
B-2 Property Line
t•d dZ1~60 00 8L ~O
ety Buildings Division
' County ~
~
'
gton Ave., P.O. Box 7162
201 W. Wash ,
~'
® ~ ~ '`" ~ ~ ~ ' ~ Madis I 53707 - 7162
.. ~ L006 6 6-3151
,~~0~ ,~ " Sanitary ertnit Number (to be filled in by Co.)
~~~ ~~~
.Department of Com erc~' ,..
s ,
Sani er`m~~'~l~pli do
State Plan LD. Number
~ -'
A ersonal i orm n you
Wi
21
C
83
,
s.
omm
.
In accord with
may be used for secondary purposes Privac , s15.04 )
~ address)
g
dress (if different than m
d
Project
A
ai~lin
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t All Information
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ease
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I. Application Informat
Property Owner's Name / Pa cf el # Block #
2osa~
Property Owner's Mailing Address Property Location
i
/V~ '/,,~"~ ''/e, Section
City; State ~ Zip Code Phone Number
~D~ ~ trcle n Z7Y /
T ~N; R E o W •
II. Type of Building (check all that apply) ,,~L ~ `
Number
t/it 4', 6`t~t SubdivisionN a
~
~
~
Family Dwelling - Number of Bedrooms ~ ~
~
~
f~
/
^ Public/Commercial -Describe Use q
L ~ $',t.. l 0 G C 5 ^City_^V~ g wnship of
~ 5
^ State Owned -Describe Use tt
III. Type of Permit: (Check only one box on line A. Complete line B if applicable) ZU ~ ~~39 -' Z3 " COb
A' ew System ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System
~~
List Previous Permit Number and Date Issued
B. ^ Permit Renewal it Revision ^ Change of ^ Permit Transfer to New
/ ~~
Before Expiration ~--~~ Plumber Owner ~ / ~ So
C7
^
IV. T e of POWTS S stem: Check all that a 1
-Pressurized In-Ground ^ Mound >_ 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter
culahi Sand Filter ^
Constructed Wetland Pressurized In- and ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recir
`
Recirculating Synthetic Media Filter Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain) d' /' .tie
V. Dis ersal/Treatment Area Information: stem Elevatio
nequired (sf) Dis`/p~~er)sLaml A~Jrea Propo d (sf) Swy77
e~a R
d)/' Design Soil Application Rate(gpdsf) Dispers
a-I
w
(gp
JA/r
I
O
De
si/gJn F
~ ~ ~~
~
a
X
j
~
'
~
J
^
~
/
/
! [/~/ O
~V V A ~ ~ V V CJ
i
(~
c
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site feel Fiber Plast
Concrete Constructed Glass
Gallons Gallons of Units
New Existing
Q
~» ~~~
~
~
Tanks Tanks v v
Septic or Holding Tani: ~ Z ~ ~ /
Aerobic Treatment Unit
Dosing Chamber
VII. Responsibility Statement- I, the undersigned, a responsibility for installation of the POWTS shown on the attached plans.
Business Phone Number
Pl be 's Name (Print) Plumber's re MP/MPRS Number
~~~u ~~3,~ Gz~ ~i~ -~~6-~~/
Plumber's Address (Street, Ci State, Z e)
/ljl~ ~ ~~ 1 J
VIII. Conn /De artment Use Onl
Sanitary Permit Fee includes Groundwater Date ssue
Issuing nt Signature o Stam
Approved ^ sappy Surcharge Fee) 7~~ Ot7 ~ ~ D
/
^ tven Reason for Denial
IX. Conditions of Approval/Reasons for Disapproval ~ 8 Jl
3 Y~1.Jbd- t5 b 1.J
SYSTEM OWNER:
taw
effluent filter and ~
nk
ti
t
S
1
j
,
ep
c
a
,
a'e.
^'`-~~
~
dispersal cell must all be serv7ces /maintained /{tia.t,°
as per management plan provided by plumber.
2. AU setback requirements must be maintained ~
~O ~,tioti ,
o
ae per ~IiCeble Code ~ tlfdtnances.
Attach complete plans (to the County only) for the system on paper not less than Sl/2 x 11 inches in siu
-e.
SBD-6398 (R. 01/03)
' ° ~ / ~~ ~
OT PLAN
' ~ ~
'PROJECT Rosamii LLC ADDRESS 2141 Ctv RD C New Richmond Wi 54017
NE 1/4 NE 1/4S 25 /T N/R 1 w TOwN Hudson COUNTY ST.CROIX
5/3/06
` 4
MFRS Shaun Bird 226900 DATE BEDROOM
CONVENTIONAL XXX IN-G ND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TA K SIZE 1255 gallons LIFT TANK SIZE DO5E TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 900 # of chambers 36
,BENCHMARK V.R.P. Top of Foundation ASSUME ELEVATION 100° Filter Zabel A-100
^ BOREHOLE O WELL *H.R.P. Same as Benchmark
Plans Designed Using
Conventional Powts SYSTEM ELEVATION 82.8/83.8 5.5' below grade
Manual Version 2.0
Well is to meet all
setbacks required by
WDNR
nVent
~6„ Arc 36 Biodiffuser
of Cover Leaching Chamber
with 25 ft2 of Area
11"
5' Long
Grade at System Elevation B.M.
~ ~„
For Replacement area
See original soil test
done by dave steel
Property Line
Pro 4
Bedroom
House
Property Line
. ,~ ~ B-
i
\ ~~,
Property Line
18% Slope
B-3
~ `
5'
30' SST
50 )-0' -I~~3
Vents
50'
Highlander Trail
/ `~ -~-
,~PROJEC~T Rosamii LLC
I~OT PLAN
ADDRESS 2141 Ctv RD C New Richmond Wi 54017
NE 1/a NE 1/as 25 /T N/R 1 w TOwN Hudson COUNTY ST.CROIX
MPRS Shaun Bird 226900 DATES/3/06 BEDROOM 4
CONVENTIONAL )OC)C IN-G ND PRESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TA K SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 900 # of chambers 36
,BENCHMARK V.R.P. Top of Foundation ASSUME ELEVATION 100' Filter Zabel A-100
^ BOREHOLE O WELL *H.R.P. Same as Benchmark
Plans Designed Using
Conventional Powts SYSTEM ELEVATION 82.8/83.8 5.5' below grade
Manual Version 2.0
Well is to meet all
setbacks required by
WDNR
nVent
>6„ Arc 36 Biodiffuser
of Cover Leaching Chamber
with 25 ft2 of Area
11"
5' Long
Grade at System Elevation B.M. * B-3 -
35"
Pro 4
Bedroom ST
For Replacement area House 30
See original soil test
done by dave steel 50
Property Line
Property Line
B-2 Property Line
5'
18°Io Slope
5'
0' _ 1 30'
Vents
50'
Highlander Trail 1 ~ ~"'`;
~r
Wisconsin Department of Commerce
Division of Safety and Buildings
f ~ •.~
~,
tt'i 4,~F `i t s,; ry
59~, EVALU~?+TIO REPORT
.,, I , .:., ~ .: .
Page ~ of
m accoraar]ce wnn ~,omm o~,,vvi~ ~.ra^m . -.,~C
~ ~ /
County ~
Attach complete site
lan on paper not less than 8 1/2 x 11 inche size an st ~
l
p
indude, but not limited to: vertical and horizontal reference point Parcel I.D.
d ~ -143 7 ~ ~ -
~C~
percent slope, scale or dimensions, north arrow, and location and distance to nearest roa .
'
Please print all information. r~~'" ~--- Revie by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). S S U
Property Owner Property Location
6 ~~ ~, ~ ~ ~ Govt. Lot ,~ 1/4/V~1/4 S ~ j'T ~ N R/ E (orj
P ~ Owners Mailing Address ~ # Block # Subd. Name or CSM#
n
3 L
City S e Zip Code Phone Number ^ City ^ Village wn Nearest Road
New Construction Use Residential / Number of bedrooms ~~ Code derived design flow rate 6/JD GPD
^ Replacement ^ Publi or commerdal -Describe: ~______. _~__________ ___
Parent material ~s-c~ ~ `-~ / Flood Plain elevation if applicable ~~~' ft.
General oam~er><s ~ j 'S- Jv~t'lgc.~~~i"'~4~
and r~eoor,unendations: 4 ~f 7 p
System Type L bi'filJ ~/ti~i~L~u~" System Elevation O~ ~J . (J
Boring # ~ Boring Q~Q
Pit Ground surface elev. v y ~ ~ R. Depth to limiting factor ~^ in.
Soil lication Rate
Horizon Depth Dominant Cdor Redox Descxiption Texture Structure Consistence Boundary Roots GP D/fP
in. Munse
ll Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#
1 'Eff#2
/
a /
Z S .~ .._--~~ ~ C.~/ ~ ~ l J
S O s i ~~1.~ i ~ J7
IL
11 ~
® ~~ # a Bonng
Pit Ground surtace elev~~ " ~ ft. Depth to limiting factor /!~~ in.
Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fP
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
O~ ~ r 1~ ~ o~ ~ ~
Z.- J D S ---_ ~
'Effluent #1 = BOD > 30 < 220 rng/L and TSS >30 < 150 'Effluent #Z = BOD < 30 mg/L and T55 < :it) mg/L
CST Name (Please Print) i re CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conducted Telephone Number
1008 192nd Ave, New Richmond, WI 54017 ~ ~.v U ~' 715-246-4516
Property Owner
n Boring # ^ Boring
Parcel ID # _
9~ ~ S~5
~ ~a i
Page of
L UJ ,'~1-Rit ~rouna surrace eiev i u • (J n. vepu~ cv urrnurx,~ iauvr ~ v~ c~ ~~ ~• Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ff
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
.~
Z- ~ -~~ 0 ~. i-/ ~,d e r
It
Boring # ^ Boring
^ Pit Ground surface elev. ft. Depth to limiting factor in.
Soil lication Rate
Horizon Depth Dominant Color Redox Desaiption Texture Structure ' Consistence Boundary Roots GPD/fF
in. MunseH Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •EffiY2
^ Bonng
~~ # Ground surface elev. ft. Depth to limiting factor in.
^ Pit Soil ication Rate
Horizon ')epth Dominant Color Redox Description. Texture Stnx~ure Consistence. Boundary Roots GP D/k=
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2
'Effluent #1 =GODS > 30 < 220 mglL and TSS >30 < 150 mglL 'Effluent #2 = GODS < 30 mglL and TSS < 30 mglL
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
580.8330 (8.6/00)
Property Owner
Parcel ID
Page of
Bori # ^ Boring ~ ~ gcy'S `
ng ~r~ " 1
,?J-•Pit Ground surface elev __~~ ft. Depth to limiting fads ~ in. Soil liption Rate
Horimn Depth Dominant Color Redox Description Texture Stn~cture Consistence Boundary Roots GP DlfI?
in. Mansell Qu. Si. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
z- ~ -zz o ~. ~`/ ~-d e ,- . 6 ~
/~ 1
~/ ~ /
2~ 1 r ~-~- S ~ ~' •-n ~ ~- 1 . ~ .
r
^ aoring # ^ Bonng
^ pit Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate
Horizon Depth Dominant Col Redox Description Texture Structure Consistence Boundary Roots GP D/ff
in. Mansell Qu. Sz. Cont.-Cola Gr. Sz. Sh. 'Etf#1 'Eff#2
^ Ong # ^ Boring
^ Pit Ground surface elev. ft. Depth to limiting fads in.
Soil ication Rate
Horizon ')epth Dominant Cola Redox Description. Texttxe Stnxxure Consistence. Boundary Roots GP D/fF
in. Mansell Qu. Sz. Cont. Cola Gr. Sz. Sh. 'Eff#1 'Eff#2
'Effluent tF1 =GODS > 30 < 220 mgJL and TSS >30 < 150 mg/l 'Effluent tY2 = BODS < 30 mglL and TSS _< 30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
sao-e33o (a.snool
• Safety and Buildings Division County /~
~~
20] W. Washington Ave., P.O. Box 7162 ~
isconsin ~
RE~II~ Sanitary Permit Number (to be filled in by Co.)
$~S/~~
®epartment of commerce
Sanita~~ Permit ~
~
~
~
~
= state Plan I.D. Number
~~
ovide
at}on
o
pe
t
Co
21
Wis
Adm
In accord with Comm 83
,
.
.
.
,
may be used for secondary purpose Privacy Law, s15.04(l)(m) Project Address (if different than mailing address)
ST. ~~ r
G
~
I. Application Information -Please Print All Inf mation t
.
C, l ,,..
~ °--
~ X95 ~
9
Property Owner's Name Parcel # Lot # Block #
Property Owner's Mailing ress ~ Property Locati
/on~
/ ~
/
City, State ~
t Zip Code
~~~` ~ Phone Number / /Lq
T~~N; cEc r W e ~, Z 7~ 1
l 1 F}c
~ 1
Su rK.
c a.~
y) o
II. pe of Building (check that app
~ me C Number
Subdivision
Pr ~
1 or 2 Family Dwelling - Number`b(Bedrooms (
~~
t ~
3 ' 1
~ t~
5 ~ / (
~ ~ ~~ a~
,
as
~ v
"
^ Public/Commercial -Describe Use
n
^ State Owned -Describe Use A i 6~^~~ Q-~~~ (CJ 13 '~ l 3 ~ G f 5 ^City_^ ilia ownship o
III. Type of Permit: (Check only one box oh;line A. Complete line B if applicable) ~ - ~rj ' z - 6 ~~
•4' w System
r ^ Replacement System~u ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System
B. .
te
^ Permit Renewal
^ Permit Revision
^''!Chan
ge of
^ Permit Transfer to New
List Previous Permit Number and Date Issued
Before Expiration Plur~rber Owner
IV. a of POWTS S stem: Check all that a l ti I o ' fie'
on -Pressurized In-Ground ^ Mound > 24 in. of suitable soil "0 Mound < 24 in. of suitable soil ^ At-Grade ^~~ e Pass Sand Filter ^
Constructed Wetl dna ^ Pressurized Tn-Ground ^ Holding Tank ~ peat Filter ^ Aerobic Treatment Unit ^ irculati Sand Filter ^
~
•~
C
'~:~ Gravel-less Pipe ^ Other (explain) .
Recirculating Synthetic Media Filter Leaching Chamber ^ Drip Line
t
V. Dis ersaUTreatmentArea nformatt n: ~-
o'n Rate(gpdsf) Dispersal Area Req ' d (sfj Dispersal Area~Proposed (s/f) QSystem Elev ~io~n
Desi Flow (gpd) Design Soil Applicati
/
VI. Tank Info Capacity in
Gallons Total
Gallons Number
of Units Manufac'4tlrer
y Prefab
Concrete Site
Constructed Steel er
Glass Plastic
New Existing I n
6t/ Za ~PSC_ ~ ~~ ~~
Tanks Tanks
Septic or Holding Tank ~.~~ l~'v.
Aerobic Treatment Unit ~,.
Dosing Chamber
VII. Responsibility Statem t- I, the?undersig time responsibility for installation of the POWTS 3hpwn on the attached plans.
Plu be 's Name (Print) :'plumb attire MP/MPRS Number Business Phone Number
~~ j 1
7
'' •`~',
~
~
~~ 7
~ ~
ess (Street, City, Stat de) /~ ~ ~`<,.
dd
r
A
Plumbe
r's
'
gq
y~
~,.
~
7
~~
vc„~ U i 1'C ~
VIII. Coun /De artment Ilse O
Sanitary Permit Fee (includes Groundwater Dat Issue Issuing ent Signatu (N tam
pproved ^ ~sapprove Surcharge Fee)
^ Owner iven Reason ial
IX. Conditions of ApprovaUReasons for Disapproval (~
SYSTEM OWNER: 3~ l~ ~ ~ l~p-C' ~M~SC"' Su~ ot-`'`I`°.'~- ~ 'r~
1. Septic tank, effluent finer artd ,
dispersal ceN must all ~ ~ ~~~- t~, I^ ~ ,~ aw. e a~--~~ ~
lded by P•
ss per msnapsnr~rtt l~ Ixov
2
~ cods ~ ardfrar+eee•
_~ __ _..-s. ...,. ~e~~ N,ov At M2 z 11 inches in size
nrtacn camp~ere p~aus tw wo ..~~...~ .,...~~ ..........,,
:e.
r-
_~
~R.
SBD-6398 (R. 01/03)
•~
r ~ tg~!r? ,4rrv !i rr ."i::144
:+,QrT!V%~,i VU r'~b3)iUJ J 16i`i ~~ri`.tC:ift;~< "!U •..
t:i9fMfih71~i1T gd Itl.:rT1 OtnA>r'.+,';i;';q~ i~J6tlh!? :i+j
t@JhaE/SlhlO '; 9L+9,t yldp;:+-y7~6 -Ni~ E6
PROJECT Rosamii LLC y f,, D SS 2141 Ctv RD C New Richmond Wi 54017
NE i/a NE 1/4S 25 /T 29 ]1~/~ 9 W TOWN Hudson COUNTY ST.CROIX
~ _
MPRS Shaun Bird 226900 DATE4/16/06 BEDROOM 4
CONVENTIONAL XXX IN-GROUND wESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1212 # of chambers 39
,BENCHMARK V.R.P. Top of 1/2" pipe ASSUME ELEVATION 100' Filter Zabel A-100
^ BOREHOLE O WELL *H.R.P. Same as Benchmark
SYSTEM ELEVATION 92.0/91.0/90.0 5' below grade
Well is to meet all 342' Pro ert Line ,...~•~
setbacks required by Plans Designed Using yam,
WDNR Conventional Powts r,;.-.x"Ay
~, Manual Version 2.0
135'
15' B~-1 Vents --~
9' 65' I I I I - R.~~'
Vent
Standard Biodiffuser
"_s Leaching Chamber
with 31.1 ft2 of Area
>6"
of Cover
6'
61'1 111111 14°Io
M. * --
A^Lt. B.M. 3-3' 83' cells with >3'
5' I
36'
20'
44'
ST
210' 15'
Pro 4
Bedroom
House
Highlander Trail
1"
,~
%~
at System Elevation
• rt,vi ~.Hlv
~•PROJECT Rosamii LLC ~D R SS 2141 Ctv RD C New Richmond Wi 54017
NE 1/4 NE 1/4S 25 /T 29 N/,hi '9/ W TOWN Hudson COUNTY ST.CROIX
~: 4/16/06 BEDROOM 4
MPRS Shaun Bird 226900 DATE
CONVENTIONAL XXX IN-GROUNIS;° ESSURE CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE
HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1212 # of chambers 39
,BENCHMARK V.R.P. TOp Of 1/2" pipe ASSUME ELEVATION 100' Filter Zabel A-100
^ BOREHOLE O WELL *H.R.P. Same as Benchmark
Well is to meet all
setbacks required by
WDNR ,
135'
15' B-1Vents
9'
65' ~B
61' 14% Slope
.M.
ALt. B.M.
5'
3 6'
20'
_ 44' _ a
ST
210' 15'
SYSTEM ELEVATION
342' Property Line
Plans Designed Using
Conventional Powts
Manual Version 2.0
Vent
92.0/91.0/90.0 5' below grade
>6„ Standard Biodiffuser
of Cover Leaching Chamber
with 31.1 ft2 of Area
6' Longll 1 "
with >3' spacin
3-3' X 83'
Pro 4
Bedroom
House
at System Elevation
Highlander Trail
~,.
Wisconsin Department of Commerce
rlivicinn of Safety and l3uildinns
SOIL EVALUATION REPORT
....~.. .,oiL. /`.,mm Rr. \A/.c Or1m C:nr1P
1290
Page 1 of 3
Steel Soil Service
. ------ - County
Attach complete site plan on paper not less than 8%: x 11 inches in size. Plan must St. Croix
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I
percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. . .
pe ing
Please print all information. Revie d By Dat
Personal information you provide may be u for ~ ~ l1) (m))~ ~ 'r7~ ~$ ~
Property Owner P party Location
ROSAMJI, L.L.C G vt. Lot na NE 1/4 NE /4 S 25 T 29 N R 19 W
Property Owner's Mailing Address L t # Block # Subd. Na or CSM#
2141 Cty Rd. C 23 na Indigo Ponds
Ci State Z Code ~ ~
~ ~~
I v ~ City ~ Village _]/ Town Nearest Road
,
~ r. ICE
New Richmond ~ WI ~ 5401 - - Hudson Hi hlanderTrail
g
i/ New Construction Use: ~ Residential / Number of bedrooms 4 Code derived design tlow rate bUU
J Replacement ~ Public or commercial -Describe:
Parent material Sream terraces and pitted outWaSh plains Flood plain elevation, if applicable
General comments
and recommendations: system elevation 92.95 tt, trenches spaced and depth to code 4.00 tt below grade' • S ~D
3~1~" Irv
na
~
Bodng # ~ Boring
1/ Pit Ground Surface elev. 96.95 ft.
Depth to
limiting factor 120 in.
Soil Application Rate
d
ti
R
D
d re
T
t Structure Consistence Boundary Roots GP D/ft2
Horizon Depth
in. Dominant Color
Munsell p
on
ox
esc
e
Qu. Sz. Cont. Color ex
u Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-4 10yr4/1 none I 2msbk mfr cs 2c .5 .8
2 4-18 10yr3/4 none sicl 2msbk mfr gw 1c .4 .6
3 18-28 7.5yr4/4 none sicl 2msbk mfr cs na .4 .6
4
28-120
7.5yr4/4
none
sl/cos
2msbk
mfr
na
na ~-
.5
.9
r
,,
.~
5'~ '
Boring # ~ Boring
N Pit Ground Surface elev. 96.95 ft. Depth to limiting factor 140 in. Soil Application Rate
Horizon Depth
in. Dominant Color
Munsell Redox Description
Qu. Sz. Cont. Color Texture Structure
Gr. Sz. Sh. Consistence Boundary Roots GP
*Eff#1 DItt~
*Eff#2
1 0-4 10yr2/1 none sil 2msbk mfr cs 2f .5 .8
Z 4-16 10yr4/4 none sicl 2msbk mfr gw 1f .4 .6
3 16-33 7.5yr4/4 none scl 2msbk mfr gw na .4 .6
4 33-72 7.5yr4/4 none Ifs 2msbk mfr gw na .5 .9
5 72-140 7.5yr4l4 none cos osg ml na na .7 1.6
olv ~ /
~~ .4
* Effluent #1 = BOD 5> 30 <_ 220 mg/L and TSS >30 < 150 mglL * Effluent #2 = BODS < 30 mg/L and T55 <su mgrs
CST Name (Please Print) Signature: CST Number
David J. Steel ~ t ~ 248956
Address Steel Soil Service Date Evaluation Conducted Telephone Number
1564 CR GG, New Richmond, WI 54017 5/2/2003 715-246-5085
•• Property Owner ROSAMJI, L.L.C Parcel ID # pending Page 2 of 3
~ nr I
$ Boring ~ tt'
Boring # 89,65 ft. Depth to limiting factor 96 in. Soil A nation Rate
/J Pit Ground Surface elev. PPI~
ri
ti T
t Structure Consistence Boundary Roots PD
Horizon Depth
in. Dominant Color
Munsell p
on
Redox Desc
Qu. Sz. Cont. Color ex
ure
Gr. Sz. Sh. *Eff#2
*Eff#1
1 0-4 10yr3/2 none I 2msbk mfr cs 2c .5 .8
2 4-19 10yr4/3 none sil 2msbk mfr gw 1 c .5 .8
3 19-48 10yr4/4 none sicl 2msbk mfr gw na .4 .6
4 48-96 7.5yr4/4 none sl/Is 2msbk mfr na na .5 .9
I
^ Boring # J Boring
_J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth
in. Dominant Color
Munsell Redox Description
Qu. Sz. Cont. Color Textun; Structure
Gr. Sz. Sh. Consistence Boundary Roots PD
*Eff#1 *Eff#2
^ Boring # ~ Boring
J Pit Ground Surtace elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth
in. Dominant Color
Munsell Redox Description
Qu. Sz. Cont. Color Texture Stricture
Gr. Sz. Sh. Consistence Boundary Roots P
*Eff#1 *Eff#2
* Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
Page 3 of 3
STEEL'S SOIL SERVICE INC.
David J. Steel
CST-POWTSM
Lic. #248956
ROSAMJI, L.L.C.
NE 1 /4,NE 1 /4,S25,T29N,R19W
Town of Hudson, St. Croix Co.
Indigo Ponds Lot 23
1564 Cty Rd GG
New Richmond,WI 54017
Bus.(715) 246-6200
Fax.(715) 246-9372
This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your
use. The location of this test may or may not be as shown, as permanent lot lines were not established at
the time the soil test was conducted. Legend
1" = 40'
• =Benchmark Ele. 100.00Ft
Top of 1/2" pvc pipe
• =Alt Benchmark Ele. 100.35Ft
Top of 1/2" pvc pipe
^ =Borings
Boring Elevations
B 1 = 96.95Ft
B2 = 96.95Ft
B3 = 89.65Ft
B4 = OO.OOFt
N
~=~~-
~z,~3
a
589°53'05"E 760.75' ` ~ y `~`~~ Y f µ ~~
~f~ '342 75"' '~' ~' ~'~~ ~ `~ •
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ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
OwnerBuyer ~, ~„~ ra-, ~ ~ ~,.. ~,,. ~
Mailing Address ZI `~1
~1 7
Property Address
City/State
(Verification
LEGAL DESCRI~~P//TION
Property Locatiorl"~ 1/4,~/%
~--~
Subdivision ~~2r.
& Zoning Department for new construction.)
Parcel Identification Number ~ZD -- /~3`3 -- Z3 ~" LZ''~
'/4 , Sec. 2 '~ T ~/ N R/~W, Town of
Certified Survey Map #
Warranty Deed #
Spec house yes no
Lot #
Volume ~ ,Page # ~
_, Volume ,Page #
Lot lines identifiable es no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper
maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into
the system can affect the function of the septic tank as a treatment stage in the waste disposal system Owner maintenance
responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the
owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site
wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is
less than 1/3 full of sludge.
Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the
standards set forth, herein, as sot by the Department of Commerce and the Department of Natural Resources, State of Wisconsin.
Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning &
Zoning Department within 30 days of the three year expiration date.
I/we certify that all statements on this form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the
property escribed above, by virtue of a warranty deed recorded in Register of Deeds Office.
Nu f r of b~room~"'
OF APPLICANT(S)
~~/
DATE
***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. ***
Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if
reference is made in the wamdnty deed.
(REV. 08/OS~
Maintenance and Contingency Plan for a Septic System
Maintenance Ptan
1. Septic Tank is to be pumped once every 3 years.
2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in
order to extend the maintenance interval of the filter.
3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of
the cells.
4.Owner agrees to limit greases, garbage, and water conditioner discharge into the system.
5. The owner agrees to save this plan.
6. Do not plant trees nor park nor drive over system.
7. Watershed is to be diverted away from system.
8. Discharge into system is not exceed those required as per Comm. 83
Contin ency Plan
ption # . If system fails, determine cause of failure, use alternate area and install new
system in tested replacement area.
Option #2. Install system at a lower elevation, by removing chambers, removing biomat,
and install new system.
Option#3. No adequate area is suitable for replacement area, and system elevation
cannont be lowered. Install holding tank as last resort.
3. Replace any other failing components as needed.
Plumber: Shaun Bird 715-246-4516
St. Croix County Zoning 715-386-4680
Pumper Tom Mondor 715-246-5148
Shaun Bird #226900
• •~ 2223P 306
• STATE BAR OF WISCONSIN FORM 5 - 2000
PERSONAL REPRESENTATIVE'S
• Document Number DEED
Judy__ Niccum. as Personal Representative ofthe estate ofFlorence K. Polen
("Decedent"), for valuable consideration conveys, without warranty, to
Ros~mi . LC Grantee, the following described real estate in t. roi
County, State of Wisconsin (the "Property) (if more space is needed, please
attach addendum):
Please see the attached legal description.
~ 1 930`
KATHLEEN H. MALSH
REGISTER OF DEED5
ST. CROIX CO. , NI
RECEIYED FOR RECORD
04/29/2003 03:00PM
PERSONAL REPRESENTATIV
tzar :
R.EC FEE: 13.00
TRAIiS FEE: 3448:80
COPY FEE:
" CC FEE
PAGE5: 2
~~
~~
•~ Recording Area
Name and Return.Address .
Edina Realty Title. ~ .
. 400 S. 2nd St., #116 c_
Hudson, W(54016 ~ 1'~~J
Personai Representative by This deed does conveyto Grantee all ofthe estate and ~ ~1~
interest in the Property which the Decedent had immediately prior to Decedent's death, Parcel Identification Number (PIN)
and all of the estate and interest in the Property which the Personal Representative has This Is not homestead property.
since acquired. - (isnot)
Dated this 28th day of April , 2003
- S~ C'.f' Cl9n,
*" ~ • Judy .Niccum
Personal Representative Personal Representative
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) Judy ,Niccum :STATE OF WISCONSIN )
ss.
ST. CROIX County )
authenticated this 28'" day of April , 2003
.Personally came before me this 28'" day of
April 2003 the above. named
• ~1r~ayP glCj `Judy.' Niccum
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not, to the known to be the person(s) who executed the foregoing
authorized by § 706.06, Wis. Stats.) instrument and acknowledged the same.
THIS INSTRUMENT WAS DRAFTED BY
Heywood, Cari & Anderson,S.C., 1200 Hoaford SL, Suite 106 •
P.O. Box 125, Hpdaon, WI 54016 Notary Public, State of WISCONSIN
My Commission is permanent. (If not, state expiration date:
(Signatures may be authenticated or acknowledged. Both are not necessary.) , .)
• Names of persons signing in any capacity moat be_ typed or printed below their signature.
STATE 6AR OF WISCONSIN
PERSONAL REPRESENTATI VE'S DEED FORM No. 5 - 3000
(a00)655.2021 www.infoprofoms.eom
2223x' 30?
Parcel A: That parcel located in part of the Northwest Quarter of the Southeast Quarter, the Northeast
Quarter of the Southeast Quarter, the Southwest Quarter of~tho Southeast Quarter, aad~the Southeast
Quarter of tho Southeast Quarter, all in Section 24, Town 29 North, Range 19 Wcst, and the Northwest
Quarter of the Nortl-oast Quarter, the Northeast Quarter of the Northeast Quarter, and the Southwest
Quarter of the Northeast Quarter, and the Southeast Quarter of the Northeast Quarter, all in Section 25,
Town 29 North, Range 19 West, Town of Hudson, County of St. Croix, State'of Wisconsin; further
described as follows:
Beginning at the south quarter corner of said Section 24; thence North 00 degrees 31 minutes OS seconds
West,.(for the purposes of this description the south line of said Southeast Quarter.assumed to bear North
89 degrees 53 minutes OS seconds West) along the North-South Quarter line of said Soctiori 24, a
distance of 158.37 feet; thence North 89 degrees 56 mimrtos 47 seconds East a distance of 794:98 feat to
the point of beginning of a tine hereinafter described as "Line A"; thence North 00 degrees 16 minutes 57
seconds Bast, along said "Line A", a distance of 1049.18 feat to the point of termination of said "Line
A"; thence North 47 degrees 03 minutes 07 seconds West a distance of l ] 8.06 feet; thence North 27
degrees 46 minutes 10 seconds West a distance of ]96.02 foot to the center line of Badlands Road; thence
North 67 degrees 30 minutes 13 seconds East, along said center line, a distance of 708.39 foot;. thence
North 67 degrees 56 minutes 31 seconds East, continuing along said center line, a distance of 674.75 feet
to the westerly line of BOUNDARY RIDGE, according to the nxorded plat thereof; thence South 00
degrees 25 minutes 17 seconds West, along said westerly line, a distance of 1826.90 feet to the southwest
corner of Lot 7, said BOUNDARY RIDGE; thence North 89 degroes 43 minutes 38 seconds West a
distance of 66.00 feet to a poiirt 66.00 foot westerly of and perpendicular to said westerly line and
hereinafter described as "Point A"; thence South 89 degrees 56 minutes 47 seconds West a distance of
961.84 feet to a point 66.00 feet easterly of and perpendicular to said "Lino A"; thence North 00 degrees
16 minutes 57 seconds East, parallel with said "Line A", a distance of 1036.45 feet; thence North 89
degrees 25 minutes 43 seconds East a distance of 82.43 feet; thence North 77 degrees 28 minutes 43
seconds East a distance of 343.87 foot; thence North 83 degrees 18 minutes 47 seconds Bast a distance of
201:86 foot; thence North 58 degrees 53 minutes 32 seconds East a distanx of 263 ~3 feet;. tlterroe North
54 .19 marnites 28 seconds East a distance of 112.69 feet; thence North 42 degrees 13 minutes 44
seconds East a distance of 46.55 feet to a point 66.00 feet westerly of and perpendicular to said westerly
line of BOUNDARY RIDGE; thence South 00 degrees 25 minutes 17 seconds West, parallel with said
westerly lino of BOUNDARY RIDGE, a distance of 1370.64 feet to saicL "Point A"; thence South 89
degrees 43 minutes 38 seeds East a distance of 66100 feet to said southwest corner of Lot 7; thence
South 00 degrees 25 minutes 17 seconds West along said westerly lime of BOUNDARY RIDGE, a
distance of 163.55 feet to the North line of said .Northeast Quarter of Section 25; thence South 89
dcgrew 53 minutes 05 seconds East, along the north line of said~Northeast Quarter and the south line of
BOUNDARY. RIDGE, . a distance of 760.7 S feet to the northeast corner. of said Northeast Quarter, thence
SoutH 00'degrees 29 minutes 03 seconds West; along the east line of said Northeast Quarter, n distance of
2616.18 feet to tho southeast comer of said Northeast Quarter; thence South 89 degrees 25 minutes 58
seconds Wesf, along the south line of said Northeast Quarter, distance of 2606.35 feet to the southwest
corner of said Northeast Quarter; thence North 00 degrees 24 minutes LO seconds West, along tho west
line of said Northeast Quarto, a distance of 2647.29 feet to the point of begimning, St. Croix County,
Wisconsin, except that part described as follows: Atl of tho Southwest'/. of the Northeast'/. and-also
the West SSO Feet of the Southeast'/. of the Northeast'/.. and Also the South 250 fact of the Southeast'/.
of the Northeast'/., except the West 550 Feet, all in Section 25; Township 29 North, Range 19, Town of
Hudson, St. Croix County, Wisconsin.
~l~I ~ ~D ~ Iaro J - ~~ (X~D ,~o- l~~ ~ ~ ~a-~D~, ~o ~ la~c~ - y~-~v ~~ ~ /or~~~~-ate
1
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Aldo V 111L[~ +N • na. u v v• w
1" O, D. X 24" ROUND STEEL PIPE 11EIGHING
1.13 LB. PER FOOT. SET
(NO°0'0"E 1.Q0) PREVIOUSLY RECORDED DATA
SBL SETBACK LINE
ELEVATIONS REFERENCED TO U.S.G.S. (NAND 29)
SPIKE IN HEST FACE OF P01IER POLE. 1ST
/ POLE EAST OF SUMAC TRAIL ON SOUTH S[DE
OF BADLANDS ROAD. ELEVATION 1006.64
~. souTHwEST
~~''-CORNER OF LOT 7.
80UNDARY RIDGE ,
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26
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NO DWEWNG
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PAGE 1 OF 1
Alt. Parcel #: 25.29.19.2749 020 -TOWN OF HUDSON
Current Xl ST. CROIX COUNTY, WISCONSIN
. `Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner
O - ROSAMJI LLC
ROSAMJI LLC
428 ORANGE ST
HUDSON WI 54016
Districts: SC =School SP =Special Property Address(es): * =Primary
Type Dist # Description * 795 HIGHLANDER CIR
SC 2611 SCH D OF HUDSON
SP 1700 WiTC
Legal Description: Acres: 2.000 Plat: 2128-INDIGO PONDS LOTS 1/57 020/03
SEC 25 T29N R19W PT NE NE INDIGO PONDS Block/Condo Bldg: LOT 23
LOT 23 (2.000AC)
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
25-29N-19W NE NE
Notes: Parcel History:
Date Doc # Vol/Page Type
07/10/2003 729699 9/71 PLAT
2006 SUMMARY Bill #: Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/25/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.000 93,100 0 93,100 NO
Totals for 2006:
General Property 2.000 93,100 0 93,100
Woodland 0.000 0 0
Totals for 2005:
General Property 2.000 93,100 0 93,100
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch #:
Specials:
User Special Code
Category
Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
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